Department of Epidemiology and Public Health, University College Cork, Cork, Ireland,
Qual Life Res. 2013 Nov;22(9):2265-78. doi: 10.1007/s11136-013-0390-0. Epub 2013 Mar 17.
To assess the impact of providing healthcare professionals with feedback on patient-reported outcome measures (PROMs).
This is a systematic review including controlled studies investigating the effectiveness of PROMs feedback, specifically examining the impact at a group-level and a patient-level.
Only one study provided feedback at a group-level as a measure of professional performance, which found no intervention effect. At a patient-level, sixteen studies were identified and only one study found an overall significant difference in the PROM score. However, an additional six studies found a significant result favouring the intervention group for a particular subgroup or domain. The studies which demonstrated the greatest impact primarily used PROMs as a management tool in an outpatient setting on a specialised patient population. In contrast, there was weak evidence supporting with the use of PROMs as a screening tool. The studies which found a positive effect had a lower quality score on average.
The effectiveness of PROMs feedback seems to be related to the function of the PROM. However, the evidence regarding the impact of PROMs feedback on patient outcomes is weak, and methodological issues with studies are frequent. The use of PROMs as a performance measure is not well investigated. Future research should focus on the appropriate application of PROMs by testing specific hypothesis related to cause and effect. Qualitative research is required to provide a deeper understanding of the practical issues surrounding the implementation of PROMs and the methodological issues associated with the effective use of the information.
评估为医疗保健专业人员提供患者报告结局测量（PROMs）反馈的影响。
这是一项系统评价，包括研究 PROMs 反馈效果的对照研究，具体考察了群体水平和个体水平的影响。
仅有一项研究将反馈作为专业表现的衡量标准提供了群体水平的反馈，结果未发现干预效果。在个体水平上，确定了 16 项研究，仅有一项研究发现 PROM 评分存在总体显著差异。然而，另外 6 项研究发现干预组在特定亚组或特定领域存在显著优势。表现出最大影响的研究主要将 PROM 作为门诊环境中特定患者群体的管理工具使用。相比之下，支持使用 PROM 作为筛查工具的证据较弱。发现积极效果的研究平均质量评分较低。
PROMs 反馈的有效性似乎与 PROM 的功能有关。然而，关于 PROMs 反馈对患者结局的影响的证据较弱，且研究中存在常见的方法学问题。PROMs 作为绩效衡量工具的使用尚未得到充分研究。未来的研究应关注 PROMs 的适当应用，通过测试与因果关系相关的特定假设来检验 PROMs 的效果。需要开展定性研究，以深入了解与实施 PROMs 相关的实际问题和与有效使用信息相关的方法学问题。
